This document provides an overview of pelvic fractures, including: 1. Classification systems for pelvic fractures including the Tile and Young-Burgess systems. 2. Diagnosis involves a history of traumatic injury and physical exam to check for signs of bleeding from the pelvis. Imaging of the pelvis is also used. 3. Management focuses on reducing pelvic volume to control bleeding through techniques such as pelvic binding, preperitoneal pelvic packing, external fixation, and angiographic embolization.

1. PELVIC FRACTURES MADE
EASY
FACEBOOK: HAPPY FRIDAY KNIGHT
Anatomy
Classification: Tile and Young-Burgess
Diagnosis
Management
Pelvic binding
external fixation
Preperitoneal Pelvic Packing (PPP)
Angiographic embolization
Reference: Mattox KL et al. Trauma. 9th ed. McGraw-Hill Medical, 2020.
https://www.freeflightphysiology.org/first-aid-skills/binding-the-pelvis/
medrxiv.org/content/10.1101/2021.02.09.21250850v1.full
https://surgeryreference.aofoundation.org/orthopedic-trauma/adult-trauma/pelvic-
ring/basic-technique/external-fixation#reduction-and-fixation
https://www.researchgate.net/figure/The-angiography-of-a-patient-with-an-unstable-
pelvic-fracture-Note-the-extravasation-of_fig8_273280198

2. PELVIC ANATOMY:
BLEEDING SITES:
VENOUS, BONE,
ARTERIAL
https://sen842cova.blogspot.com/2015/10/pelvi
c-artery-anatomy.html
https://www.britannica.com/science/pelvis

3. CLASSIFICATI
ON
YOUNG-BURGESS • LC – lateral impact
• APC – open book
• VS – fall from height

4. • Tile
• A - stable
• posterior ligament intact
• B – partially stable
• Vertically stable
• Rotationally unstable
• C – unstable
• Both vertically and rotationally
unstable
• Complete disruption of SI complex

5. DIAGNOSIS
• Hx: dangerous mechanism
• PE: DO NOT perform pelvic compression test if suspected pelvic
fracture
• Inspect perineum and skin overlying pelvic bones
• Look for urethral injuries signs
• PV
• Imaging: pelvis AP

6. MANAGEMENT: REDUCE PELVIC VOLUME TO REDUCE
BLEEDING
• Pelvic binding
• Bed sheet or commercial kit
• Center of the binder: greater trochanter
• Internal rotation and
tight the legs
• Limitations:
• pressure ulcers
• PPP
• Suprapubic incision
• 3 packing swab each side
of the bladder deep to pelvis
• Limitation: require removal
• External fixation
• Stabilize fx element
• Decrease pelvic volume
• Allow clot to form
• Limitation: require skill
and equipment
• Angiographic embolization
• Nonselective
• Limitations: not widely available